B. Gardlund et al., PLASMAPHERESIS IN THE TREATMENT OF PRIMARY SEPTIC SHOCK IN HUMANS, Scandinavian journal of infectious diseases, 25(6), 1993, pp. 757-761
14 patients (mean age 25.5 yrs) with life-threatening primary septic s
hock were eligible for treatment with acute plasmapheresis in a prospe
ctive study. They had a short history of sepsis and had no severe unde
rlying disease. 10/14 patients had systemic meningococcal disease. All
patients were severely ill with a mean APACHE II score of 25.0. 12/14
patients were treated with plasmapheresis exchanging 1 plasma volume
within hours of admission. 11/14 patients survived without major seque
lae and 3 (21%) died of irreversible septic shock. This mortality is l
ower than that predicted from the APACHE II scores (55.2%). A subgroup
of plasmapheresis-treated patients with septic shock and extensive pe
techiae were compared to a historical control group. The mortality in
the treatment group was 1/7 (14%) versus 8/21 (38%) in the control gro
up. We conclude that acute plasmapheresis may be a therapeutic option
in the early stages of severe primary non-surgical septic shock.